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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 May 26; 334(7603): 1080.
PMCID: PMC1877887
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US health care no longer “best in the world”

A fundamental change has occurred in the way US citizens view their health service, writes one bioethicist. The public has finally accepted that health care in the US is no longer “the best in the world,” and politicians, journalists, or anyone else who repeats that now historical phrase is more likely to be laughed at than applauded for their patriotism. The deficiencies are so widespread that even the rich can no longer buy protection from medical errors, iatrogenic infections, or system failures.

Other previously cherished notions have also been abandoned, he writes. Firstly, few people still believe that health care is so special that it is exempt from all consideration of cost. Spending on health care means less money for other essentials such as food, heating, and education. Health care, just like other social goods, must represent good value.

Secondly, Americans are ending their longstanding love affair with new drugs and technologies. It may still be possible to say “new is better” on television without risking ridicule, but high profile failures such as rofecoxib, hormone replacement therapy, and megadose antioxidants mean that plenty of viewers will disagree.


  • JAMA 2007;297:2131-3

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